Background: Inflammatory bowel disease (IBD) is a chronic immune-related condition caused by interactions between genetics, immune dysfunction, gut microbiota changes, and environmental factors, often presenting as persistent or recurring diarrhea. Clinically, it commonly presents with chronic diarrhea and other gastrointestinal symptoms. The global prevalence of IBD is increasing, currently affecting approximately 0.5% of the population, with projections suggesting a rise to nearly 1% by 2030. Fecal calprotectin is a neutrophil-derived S100 calcium-binding protein that is elevated in intestinal mucosal inflammation and serves as a reliable noninvasive biomarker of inflammatory activity. Due to its high stability and close association with intestinal inflammatory activity, fecal calprotectin has been established as a dependable, non-invasive marker for identifying intestinal inflammation. In clinical practice, it is extensively used to distinguish IBD from functional gastrointestinal disorders, especially irritable bowel syndrome, among patients presenting with chronic diarrhea. However, its diagnostic utility in Mongolia remains underexplored, and this study aims to determine its sensitivity and specificity in inflammatory bowel disease and compare its diagnostic performance with other inflammatory markers. Aim: To determine the sensitivity and specificity of fecal calprotectin in inflammatory bowel disease and to compare it with other inflammatory markers. Materials and Methods: A total of 109 participants aged 18-87 years with chronic diarrhea, who attended the gastroenterology outpatient clinics of the Mongolia–Japan Hospital and Intermed Hospital between December 2024 and December 2025 and provided informed consent, were enrolled in this study. Data were collected using structured questionnaires, and laboratory investigations included complete blood count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and measurement of fecal calprotectin levels from stool samples. Based on fecal calprotectin results, selected participants underwent colonoscopic examination as clinically indicated. Results: Among the 109 participants included in the study, 17.4% were diagnosed with inflammatory bowel disease (IBD), with a mean age of 47.41±15.52 years. Fecal calprotectin levels were significantly higher in the IBD group compared to the control group (p<0.001). Fecal calprotectin demonstrated a weak positive correlation with C-reactive protein (CRP) and leukocyte count (p=0.042, p=0.06), while no significant correlation was observed with erythrocyte sedimentation rate (ESR). At a cutoff value of 250 µg/g, fecal calprotectin showed a sensitivity of 94.4%, specificity of 69.2%, positive predictive value (PPV) of 37.8%, and negative predictive value (NPV) of 98.4%. Receiver operating characteristic (ROC) curve analysis identified an optimal cutoff value of approximately 400 µg/g (AUC=0.919, Youden index=0.724), at which the sensitivity remained 94.4% and specificity increased to 78.0%. In contrast, CRP and ESR demonstrated comparatively lower diagnostic performance, with AUC values of 0.640 and 0.644, respectively. Conclusion This study demonstrates that fecal calprotectin has superior diagnostic performance compared to conventional inflammatory markers in differentiating inflammatory bowel disease (IBD). An optimal cutoff value of approximately 400 µg/g yielded the highest sensitivity and specificity. Therefore, fecal calprotectin may serve as a valuable tool in clinical practice for both screening and diagnostic confirmation.

Background: Allergic and atrophic forms of chronic rhinitis are common among the population, characterized by a chronic progressive course with a tendency toward increasing prevalence. Worldwide, allergic rhinitis affects approximately 10–40% of adults and 2–25% of children. According to a study conducted in Mongolia, the prevalence of allergic rhinitis among adults in Ulaanbaatar was reported to be 23.6%, with an increasing trend anticipated in the future. In allergic and atrophic rhinitis, structural alterations occur in the nasal mucosa, including disruption of the normal architecture of the pseudostratified epithelium and ciliated cells, accompanied by changes in goblet cell number and dysfunction of their activity, resulting in a complex pathological process. In otorhinolaryngology practice in Mongolia, there is a relative lack of studies investigating the ultrastructural changes of the nasal mucosa in allergic and atrophic rhinitis. Aim: To compare ultrastructural and histological changes of the nasal mucosa in allergic and atrophic rhinitis. Materials and Methods: Ethical approval was obtained from the Research Ethics Review Committee of the Mongolian National University of Medical Sciences at the meeting held on April 24, 2020 (Protocol No. 2020/З-04). Appropriate ethical permission was also obtained from the EMJJ ENT Hospital. Nasal mucosal tissue samples were collected from surgically resected specimens of patients aged 20–45 years diagnosed with allergic and atrophic rhinitis. The mucosal specimens were processed at the Institute of Biomedical Sciences of the Mongolian National University of Medical Sciences. Samples were fixed and dehydrated according to the protocol, coated with 100 Å gold, and examined using a scanning electron microscope (FEI Quanta FEG 250, USA). In addition, paraffin blocks were prepared, sectioned at 4 μm thickness, stained with Hematoxylin and Eosin, and analyzed histologically. Results: In allergic rhinitis, the pseudostratified epithelium was relatively preserved; however, disorganization of ciliated cells, partial loss of cilia, and goblet cell hyperplasia were observed. In contrast, atrophic rhinitis showed epithelial thinning, near-complete loss of ciliated structures, glandular atrophy, and submucosal fibrosis. Conclusion Allergic rhinitis is associated with relatively mild and predominantly functional mucosal alterations, whereas atrophic rhinitis demonstrates severe structural damage with irreversible impairment of mucosal protective function.

Background: Hypokalemia is considered when the serum potassium level is less than 3.5 mmol/L. Clinical research indicates that hypokalemia affects 20% of hospitalized patients, and in 24% of these cases, inadequate interventions result in life-threatening complications. At present, there is no research available on the prevalence, management, and outcomes of hypokalemia in hospitalized patients, which justifies the need for this study. Aim: The study aimed to examine the prevalence of hypokalemia and the effectiveness of its management in hospitalized patients within the internal medicine department, in relation to the knowledge of doctors and resident physicians. Materials and Methods: This hospital-based retrospective study included a total of 553 cases of patients hospitalized in the Internal Medicine Department of the Mongolia Japan Hospital between January 2024 and August 2024. Patients with a potassium level of <3.5 mmol/L were diagnosed with hypokalemia, and the effectiveness of potassium replacement therapy was evaluated according to the method of supplementation employed. Results: The prevalence of hypokalemia among hospitalized patients in the Internal Medicine Department was 9.8% (54 cases). Based on the study criteria, 42 cases of hypokalemia were selected for further analysis, and a total of 118 potassium replacements were performed through oral, intravenous, and mixed methods. Following potassium replacement therapy, 37.3% (44) of patients achieved normalized potassium levels, while 62.7% (74) still had persistent hypokalemia. Conclusion According to the study results, the prevalence of hypokalemia among hospitalized patients in the Internal Medicine Department is 9.8%. The method of potassium replacement and the severity of hypokalemia do not impact the normalization of potassium levels, with the critical factor being the proper dosage of supplementation. The knowledge of doctors and resident physicians regarding hypokalemia is insufficient, and there is a need to implement guidelines and protocols for potassium replacement therapy in daily clinical practice.

Background: Systemic sclerosis-related interstitial lung disease (ILD) is a major cause of mortality among patients with systemic sclerosis. During this disease, when the forced vital capacity (FVC) is <50% on spirometry, the prognosis is considered poor. Although early changes in systemic sclerosis-related ILD can be identified by chest computed tomography (CT), evaluating the spirometry test is essential for monitoring further follow-up and assessing treatment outcomes. This study aimed to highlight the importance of considering the role of the spirometry test among patients with systemic sclerosis. Materials and Methods: We conducted this study using a cross-sectional research design based at a single-center hospital. The study included 40 patients diagnosed with systemic sclerosis who were attending the rheumatology outpatient clinic at the Mongolia-Japan Hospital. The inclusion criteria were patients diagnosed with systemic sclerosis who had undergone chest imaging (chest x-ray, chest CT scan) and spirometry tests. Results: In our study, in 62.5% of patients diagnosed with systemic sclerosis, a chest CT scan revealed abnormalities indicative of SSc-ILD. There were statistically significant differences (p<0.05) in certain parameters of spirometry between the two groups (normal chest CT, abnormal chest CT). The group with abnormal chest CT had a higher usage of mycophenolate mofetil (p<0.05). A negative correlation was found between changes on chest CT scan and FVC (r= -.453, p<0.05). However, no statistically significant correlation was observed between FVC and disease duration or comorbidities. Conclusion Using spirometry to assess pulmonary function in patients with systemic sclerosis-related interstitial lung disease may be an appropriate method for evaluating the progression of the disease and detecting complications.

Introduction: Since 1993, the Inula helenium L. plant has been planted in the production area (Bulgan Province, Dashinchilen Sum) of the Traditional Hatchery Science and Production Corporation’s medicinal plant introduction and cultivation experience. At the Drug Research Institute, there is also a botanical institute for medicinal plants where it is grown. In traditional Mongolian medicine, the roots and rhizomes of Inula helenium L. are used to reduce inflammation, boost immunity, enhance hunger, and improve intestinal motility. Inula helenium L. roots and rhizomes contain biologically active compounds such as monoterpenes, sesquiterpenes, phenols, flavonoids, and polysaccharides. Methods: The roots and rhizomes of Inula helenium L. were extracted with water and 70% ethanol at the following ratios 1:10 (2% of WAC), 1:8, and 1:6 by partial maceration at 700C for 2 hours each, extracted and concentrated. The dry extract was obtained by the spray drying procedure. High-performance liquid chromatography for determining the content of alantolactone, thin-layer chromatography for qualitative analysis. Spectrophotometer for determining the content of polyphenolic compounds, colored compounds with Folin-Ciocalteu reagent for qualitative analysis. Spectrophotometer for determining the content of inulin, and colored compounds with phenol and sulfuric acid solutions for qualitative analysis. Conclusion In determining the content of polyphenolic compounds, inulin, and alantolactone in the dry extract taken from the roots and rhizomes of cultivated Inula helenium L., the content of polyphenolic compound in dry extract A was 2.50±0.08%, and alantolactone was 1.39±0.11% in the raw material of the plant, while B dry the extract had a high concentration of inulin of 58.51±0.66%.

The Jerusalem Artichoke (JA) (Helianthus tuberosus L.) is an annual plant native to North America and widely distributed in Europe and Central Asia. The tuber of JA contains 80% water, 15% polysaccharide (Inulin etc.), 2% protein, and a small amount of starch and fat. Inulin is a polysaccharide that is widely used as a prebiotic, fat substitute, and sugar substitute. This substance has high biological activity and is contained in large quantities.
The purpose of this study was to standardize the quality and safety of dried tubers of JA. Standardization includes parameters such as microscopic analysis, identification, quantification, validation of methods following the guidelines issued by ICH guidelines, and quality, including safety analysis (appearance, moisture, mechanical impurities, heavy metals, microbiological purity).
The content of inulin was 64.17±1.25%. The mean relative standard deviation of method validation (RMS%) was 1.27%, 1.18%, 1.22%, and the relative mean standard deviation (RMS) of method precision was 1.94%. The specific absorbance was 307 nm. The correlation coefficient R2=0.9998 was obtained for the reference curve of the standard substance. The detection limit of the method was 2.64 μg/ml, and the detection limit was 7.99 μg/ml.
The method mentioned above has been confirmed to be suitable for the quantitative determination of inulin in the tuber of JA. Moreover, Microbiological purity and heavy metal requirements are met.

Knowledge, attitude and practice (KAP) about breastfeeding among postpartum mothers in Bayan-Ulgii province Background: Breastfeeding stands as a crucial determinant for the health of both mothers and newborns. However, its declining rates, observed globally including in Mongolia, pose a significant concern. Investigating the underlying causes of this decline is imperative for addressing this pressing issue. Materials and methods: Using the cross-sectional study design, we randomly selected postpartum mothers and assessed their knowledge, practices, and attitudes toward breastfeeding. This evaluation was conducted using a questionnaire derived from the Maternal and Child Health Book, distinguishing between primiparous and multiparous mothers from January to July, 2023. Results: The study comprised 112 mothers, including 36 primiparous and 76 multiparous mothers. A notable finding was the lack of pregnancy preparation among the majority of mothers, with only 67% reporting preconceptional folic acid intake, notably lower among primiparous mothers at 33%. Furthermore, 78.6% of mothers had not received prenatal training. Significantly, a higher proportion of multiparous mothers (72.7%) exhibited positive attitudes towards night breastfeeding compared to primiparous mothers (27.3%), indicating a statistically significant difference (p=0.003). Additionally, primiparous mothers demonstrated a lower attendance rate for breast preparation training (p=0.005), potentially leading to increased challenges with breast attachment (p=0.049) and nipple damage issues. Conclusions: The findings highlight concerning levels of unpreparedness for pregnancy among mothers, coupled with inadequate breast preparation, particularly evident among first-time mothers, leading to potential commitment issues and nipple complications. Further investigation is warranted, as these factors may contribute to the rising consumption of infant formula in the future.

Нойр булчирхайн цочмог үрэвсэл, эмнэлзүйн урьдчилан тооцоолох дүрэм, Ranson –ийн шалгуур, APACHE II-ийн шалгуур A clinical prediction rule is a type of medical research study in which researchers try to identify the best combination of medical sign, symptoms, and other findings in predicting the probability of a specific disease or outcome. More than 80% of all patients with acute pancreatitis recover promptly without developing severe pancreatitis. The presence of early organ failure (within 24 hours of admission), multiple-organ system failure, and persistent or progressive (present beyond 48 hours after admission) organ failure are associated with prolonged hospitalization, ICU admission, need for surgery, and death. In high developed country, Ranson and APACHE II prognostic criteria are used in order to evaluate patient´s situation and modified treatment tactics. That is give an idea us to carry out retrospective study, by using patients´ documents, who hospitalized in National central hospital in last year. As result, according to Ranson´s criteria 13 (31.7%) of all patients had 0-2 score, which means mortality risk was 1.8%, 20 (48.8%) had 3-4 score (mortality risk is 11%), 8 (19.5%) were estimated 5-6 score, having 33% of mortality risk. Whereas, regarding to APACHE-II criteria 14 (34.2%) of total patients had score of 0-4, showing 4% of mortality risk, 23 (56.1%) were scored 5-9, having 8% of risk, 3 (7.3%) were scored 10-14, having 15% of risk, 1 (2.4%) had 15-19 score, having 24% of risk. Moreover, we determined that incomplete laboratory test, meaning essential prognostic criteria not used in Mongolia.